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Neumol Cir Torax. 2019; 78 (Supl 2): S164-S172 www.medigraphic.com/neumología Revisión Neumología y Cirugía de Tórax NCT Vol. 78 -Supl. 2 / 2019 dx.Trabajo recibido: 15-V-2015; aceptado: 26-V-2015. RESUMEN. La prueba de caminata de 6 minutos (PC6M) evalúa de forma integrada la respuesta de los sistemas respiratorio, cardiovascular, metabólico, músculo esquelético y neurosensorial al estrés impuesto por el ejercicio. La integración funcional se analiza mediante la distancia máxima que un individuo puede recorrer durante un período de seis minutos caminando tan rápido como le sea posible. La PC6M constituye una herramienta confiable en el diagnóstico, estadificación, pronóstico y seguimiento de individuos con enfermedades respiratorias crónicas. El presente documento unifica las recomendaciones internaciones del año 2002 y las del 2014 y aporta herramientas necesarias para estandarizar la PC6M. Palabras clave: Caminata de 6 minutos, estandarización, procedimiento, función pulmonar. ABSTRACT. The six-minute walk test (6MWT) comprehensively evaluates the respiratory, cardiovascular, metabolic, musculoskeletal and sensorineural responses to exercise. Functional integration is analyzed by the maximum distance that an individual is able to walk, as fast as possible, during a period of six minutes. The 6MWT is a reliable tool for the diagnosis, staging, prognosis and follow-up of patients with chronic respiratory diseases. This document unifies the 2002 and 2014 international recommendations and provides information needed to standardize the 6 MWT. S166 www.medigraphic.org.mx Neumol Cir Torax. 2019; 78 (Supl 2): S164-S172 Gochicoa-Rangel L et al. Prueba de caminata de seis minutos www.medigraphic.org.mx Neumol Cir Torax. 2019; 78 (Supl 2): S164-S172 Gochicoa-Rangel L et al. Prueba de caminata de seis minutos El día de la prueba y a la llegada del paciente se deberá:

Neumol Cir Torax. 2019; 78 (Supl 2): S135-S141 www.medigraphic.com/neumología www.medigraphic.org.mx Revisión Neumología y Cirugía de Tórax NCT Vol. 78 -Supl. 2 / 2019 dx.doi.org/10.35366/NTS192FRESUMEN. La medición de las presiones inspiratoria (Pi max ) y espiratoria (Pe max ) máximas permite evaluar la fuerza de los músculos respiratorios. Son mediciones sencillas, rápidas y no invasivas. Consisten en que el paciente debe generar la máxima presión inspiratoria (a partir de volumen residual) y espiratoria (a partir de capacidad pulmonar total) contra un sistema ocluido. La Pi max evalúa principalmente la fuerza diafragmática; mientras que Pe max , la de los músculos intercostales y abdominales. Las presiones respiratorias máximas (PRM) resultan de gran utilidad clínica en el diagnóstico y seguimiento de enfermedades que afectan a los músculos respiratorios. Con el objetivo de mejorar la calidad y facilitar la realización de la medición de las PRM, revisamos las recomendaciones internacionales en materia de este procedimiento y emitimos lineamientos locales que contribuyen a un mejor proceso de estandarización.Palabras clave: Presión inspiratoria máxima, presión espiratoria máxima, función pulmonar, procedimiento, fuerza muscular, músculos respiratorios, diafragma.ABSTRACT. The measurement of maximal inspiratory (MIP) and expiratory (MEP) pressures assess the strength of the respiratory muscles. These test are a simple, quick, and noninvasive. It consists that the patient must generate peak inspiratory (from residual volume) and expiratory pressure (from total lung capacity) against an occluded system. MIP assesses the diaphragmatic strength; while MEP assess the intercostal and abdominal muscles. Maximum respiratory pressures are of great clinical utility in the diagnosis and monitoring of diseases affecting the respiratory muscles. In order to improve quality and facilitate the realization of the measurement of MIP-MEP, we review international recommendations on this procedure and issue local guidelines that contribute to a better standardization process.

Given the high prevalence of multiple non-communicable chronic diseases in Mexico, the aim of the present study was to assess the association between dietary patterns and sleep disorders in a national representative sample of 5076 Mexican adults (20–59 years) from the 2016 National Health and Nutrition Survey. Through a cross-sectional study, we used the Berlin sleep symptoms questionnaire to estimate the proportion of adults with insomnia, obstructive sleep apnoea (OSA) and other related problems such as daytime symptoms and inadequate sleep duration. Dietary data were collected through a seven-day semi-quantitative food frequency questionnaire, and dietary patterns were determined through cluster analysis. Associations between dietary patterns and sleep disorders were assessed by multivariate logistic regression models adjusted for age, sex, well-being, rural/urban area type, geographical region, tobacco use, physical activity level and energy intake. Three dietary patterns were identified: traditional (high in legumes and tortilla), industrialised (high in sugar-sweetened beverages, fast foods, and alcohol, coffee or tea) and mixed (high in meat, poultry, fruits and vegetables). Multivariate logistic regression showed that the industrialised pattern yielded higher odds for daytime symptoms (OR 1⋅49; 95 % CI 1⋅12, 1⋅99) and OSA (OR 1⋅63; 95 % CI 1⋅21, 2⋅19) compared with the traditional pattern. In conclusion, dietary patterns are associated with sleep disorders in Mexican adults. Further research is required to break the vicious cycle of poor-quality diet, sleep symptoms and health.

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Fraction of exhaled nitric oxide (FeNO) is a marker of eosinophilic airway inflammation. Altitude above sea level can affect measurements of this index, but there is only limited information regarding the diurnal variation (ante meridiem vs. post meridiem) and reproducibility of FeNO on consecutive days at moderate altitudes. To evaluate the diurnal variability of FeNO and assess its reproducibility over five consecutive days in healthy individuals living at 2240 m, and to compare the FeNO readings taken with two different analyzers. Healthy non-smoking adults were measured using NIOX MINO(®) or NOA 280i(®) devices. One group (n = 10) had readings taken morning and afternoon for five consecutive days with the NIOX MINO(®) equipment; while the second group (n = 17) was measured on only one morning but by both the electrochemical analyzer (NIOX MINO(®)) and the chemiluminescence method (NOA 280i(®)). The study group consisted of 27 subjects aged 28.7 ± 6 years. Morning and afternoon FeNO measurements were 15.2 ± 7.5 ppb and 15.2 ± 7.9 ppb (p = 0.9), respectively. The coefficient of variation (CV) of these measurements (a.m. vs. p.m.) was 10.7 %, and the coefficient of repeatability (CR), 4.2 ppb. The concordance correlation coefficient (CCC) between the two measures (morning vs. afternoon) was 0.91. The CV and CR of the five morning readings were 15.4 % and 4.3 ppb, respectively; while those of the five afternoon measures were 13.6 % and 3.5 ppb, respectively. The CCC between the NIOX MINO(®) equipment and the NOA-280i(®) device was 0.8, with 95 % limits of agreement of -8.35 to 0.29 ppb. In adults living at 2240 m above sea level, FeNO measurements show minimal diurnal variation, and readings are reproducible (<15 %) over a period of at least five consecutive days; however, the FeNO measurements obtained with the NIOX MINO(®) and NOA 280i(®) devices are not interchangeable due to the wide limits of agreement recorded.

Objetivo. Estimar la prevalencia nacional de síntomas asociados con el sueño (SAS) en México, y su distribución por región, localidad y sexo. Material y métodos. Estu­dio transversal con muestreo probabilístico, representativo a nivel nacional en adultos mayores de 20 años. Se aplicó un cuestionario sobre duración de sueño, insomnio, uso de hipnóticos y riesgo de síndrome de apnea obstructiva del sueño (SAOS). Resultados. Los SAS más frecuentes fueron ronquido (48.5%) y dificultad para dormir (36.9%). Se identificó riesgo elevado de SAOS en 27.3% de los adultos, y se incrementa por índice de masa corporal (RM=1.1), edad (RM=1.03) y habitar zona urbana (RM=1.37). Se reportó insomnio en 18.8% de los participantes, que predomina en mujeres (RM=1.88). La duración promedio de sueño fue de 7.6 ± 3 horas; 28.4% de los adultos duermen <7 horas/ noche. Conclusiones. Existe una elevada prevalencia de SAS. Uno de cada cuatro adultos mexicanos tiene elevada probabilidad de padecer SAOS. La detección y tratamiento de SAS pudieran minimizar los efectos deletéreos en la salud.